CONIFER PARK, INC.


Address: 79 Glenridge Rd, Cottage #1, Glenville, NY 12302-4523
Phone: 5189528121

CONIFER PARK, INC. (NPI# 1336339969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336339969
Entity Type Organization
Organization Name CONIFER PARK, INC.
Practice Address 79 Glenridge Rd
Cottage #1
Glenville
NY 12302-4523
Mailing Address Po Box 417153
Boston
MA 02241-7153
Practice Telephone 5189528121
Practice Fax Number 5189528287
Mailing Telephone 5189528140
Mailing Fax Number 5189528287
Enumeration Date 2007-07-30
Last Update Date 2013-03-26
Authorized Official Name BARBARA A PETTEYS (DIRECTOR OP BILLING)
Authorized Official Telephone 5189528140
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
081110730 NY Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NY 01420800 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1730379504 Conifer Park, Inc. Clinic/Center 323 Lake Hill Road, Hawley Cottage, 1st Floor, Burnt Hills, NY 12027-9772 2007-07-27
1346296720 Conifer Park, Inc. Clinic/Center 80 Sharron Ave, Plattsburgh, NY 12901-4700 2006-05-26
1235185612 Conifer Park, Inc. Clinic/Center 556 Clinton Ave S, Rochester, NY 14620-1105 2006-05-26
1366498768 Conifer Park, Inc. Clinic/Center 526 Old Liverpool Rd, Liverpool, NY 13088-6238 2006-05-26
1972558179 Conifer Park, Inc. Clinic/Center 55 Elm St, Glens Falls, NY 12801-3549 2006-05-24
1356396543 Conifer Park, Inc. Clinic/Center 2435 6th Ave, Troy, NY 12180-2227 2006-05-24
1154652709 Conifer Park, Inc. Substance Abuse Rehabilitation Facility 15 Henning Rd, F. Donald Myers Education Center, Saratoga Springs, NY 12866-3749 2010-01-21
1366632986 Conifer Park, Inc. Clinic/Center 216 Main St, Suite #2, Hudson Falls, NY 12839-1813 2007-07-30
1023208139 Conifer Park, Inc. Clinic/Center 1051 Dix Ave, Buildings E and G, 1st Floors, Hudson Falls, NY 12839-1053 2007-07-26
1649225897 Conifer Park, Inc. Clinic/Center 600 Franklin St, Schenectady, NY 12305-2100 2006-05-24

Other Data Sources

Entity Type Entity Name Entity Address
New York State Corporations CONIFER PARK, INC. 79 Glenridge Road, Glenridge, Ny 12302

Office Location

Street Address 79 GLENRIDGE RD
COTTAGE #1
City GLENVILLE
State NY
Zip Code 12302-4523

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083645535 Christopher J Rizzo Internal Medicine 79 Glenridge Rd, Glenville, NY 12302-4523 2006-07-05
1538726229 Samuel John Halajian Physician Assistant 79 Glenridge Rd, Glenville, NY 12302-4528 2019-05-29
1801235155 Elizabeth Magliocca Registered Nurse 79 Glenridge Rd, Cottage #1, Glenville, NY 12302-4523 2013-06-20
1093158453 Kristen Rizzuto Counselor 79 Glenridge Rd, Cottage #1, Glenville, NY 12302-4523 2013-04-16
1043515380 Nicole Lifite Registered Nurse 79 Glenridge Rd, Glenville, NY 12302-4523 2011-01-18
1073829578 Patricia Anne Pulver Physician Assistant 79 Glenridge Rd, Glenville, NY 12302-4523 2010-08-23
1588843569 Mirabelle Beck Nurse Practitioner 79 Glenridge Rd, Glenville, NY 12302-4523 2007-10-26
1336344258 Matthew Levine Physician Assistant 79 Glenridge Rd, Glenville, NY 12302-4523 2007-06-20
1740364215 Timothy Donnelly Physician Assistant 79 Glenridge Rd, Glenville, NY 12302-4523 2006-10-24
1518057272 Danesh Irani Physician Assistant 79 Glenridge Rd, Glenville, NY 12302-4523 2006-10-13
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053921973 Maria Magnoua Castaneda Case Manager/Care Coordinator 701 Carnbridge Manor Dr., Scotia, NY 12302 2020-08-05
1184050353 Empire Vision Centers, Inc Eyewear Supplier (Equipment, not the service) 10 Glenridge Rd Store#1, Glenville, NY 12302 2013-09-19
1265773212 Caroline M Lupi Licensed Practical Nurse 19 Glenridge Rd Ste E, Glenville, NY 12302 2013-03-14
1477805844 Kinum Chiropractic PC Chiropractor 201glen Ave., Scotia, NY 12302 2012-10-10
1558686444 Marsha M Tulloch Licensed Practical Nurse 125 Mohawk Ave, Gentle Home Health Care, Scotia, NY 12302 2010-04-02
1841515988 Maureen K. Hansen Licensed Practical Nurse 109 Mohawk Ave., Gentle Home Health Care, Inc., Scotia, NY 12302 2010-04-01
1275858425 Flora Lynn Worden Licensed Practical Nurse 109 Mohawk Ave, Scotia, NY 12302 2010-03-31
1255654943 Kevin Daniel Valade Pharmacist 257 Saratoga Rd., Glenville, NY 12302 2010-03-09
1356574149 Ann Elizabeth Helbling Community Health Worker 419 Weatherwax Road, Glenville, NY 12302 2009-08-27
1689811317 Roger Guy Singer Chiropractor 353 Saratoga Road, Scotia, NY 12302 2009-01-16
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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Competitor

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City GLENVILLE
Zip Code 12302

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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